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Sclerosing Cholangitis

the liver gallbladder bigLiver disease is serious and requires treatment and regular monitoring by a liver specialist.

A liver specialist is known as a hepatologist and you need to be referred by your family doctor or general practitioner. Over nearly 40 years of practicing medicine I have seen many patients develop severe liver disease, which sadly could have been prevented by early detection and early referral to a hepatologist. There needs to be more awareness of liver disease so that patients can be treated early so that we can prevent cirrhosis, liver failure and liver cancer. Make sure you have your liver function checked annually with a blood test.

I have presented my ideas on how to help those with liver diseases using nutritional medicine, which I have been using for many years with good success rates. However my recommendations do not replace the care of your own doctor and you should remain under the care of your own doctor whilst using nutritional therapies.

If you have any questions you may contact my naturopaths on 623 3343232 or email us at contact@liverdoctor.com

Sclerosing Cholangitis

This is an inflammatory disease of the bile ducts, which eventually become scarred and narrowed ducts (tubes). Sclerosing Cholangitis is autoimmune in origin, which means that the immune system produces antibodies, which attack the bile ducts in the liver. This is supported by the fact that 50% of patients with Sclerosing Cholangitis have inflammatory disease of the bowel.

The word sclerosing means scarring and the scar tissue can narrow and distort the structure of the large and small bile ducts. The liver cells surrounding the bile ducts also become inflamed and this is why the liver enzymes are elevated in a liver function blood test.

There may be no definite symptoms, except for general fatigue and it may be picked up in a blood test by finding a high level of the liver enzyme alkaline phosphatase. In more severe cases, symptoms such as itching skin (pruritus), abdominal pain and yellow discoloration of skin and eyes (jaundice) may occur.

The veins in the liver may become blocked by scar tissue, which causes an increase in the venous pressure in the liver. This is called portal hypertension. A biopsy (tissue sample) of the liver confirms the diagnosis of Sclerosing Cholangitis.

The outcome is variable with 50% of patients being able to have a reasonably normal life. Strong anti-inflammatory drugs are sometimes helpful, but not without side effects. Those who do poorly will require a liver transplant.

Nutritional Medicine for Sclerosing cholangitis

Sclerosing cholangitis can respond very well to a change in the diet and I have had several patients with this problem who have been able to return their liver function to normal, after adopting my dietary strategies. However, they have found that the liver function becomes abnormal again if they do not maintain a suitable diet.

Avoid all dairy products (cow’s milk, butter, cheese, cream and ice cream), preserved meats and deep fried foods. It is important to follow a strict gluten free diet, as gluten will aggravate the inflammation in the liver. Gluten is found in wheat, rye, barley and oats.

Pay careful attention to any drugs or medications because they may aggravate your liver inflammation. Check with your doctor before taking them.

Anti-inflammatory supplements to reduce the inflammation in the bile ducts include:

  • The antioxidant vitamins – vitamin C 2000mg daily and vitamin E 1000 IU daily.
  • Selenium exerts a powerful anti-inflammatory effect and the dosage required is 200mcg daily.
  • A liver formula containing St Mary’s Thistle, B vitamins and sulfur containing amino acids
  • N Acetyl Cysteine (NAC) capsules in a dose of 600mg three times daily.
  • If indigestion and bloating after eating is a problem a supplement of ox bile capsules and digestive enzyme capsules taken in the middle of meals can help.
  • Raw vegetable juices containing a mixture of carrot, celery, mint, parsley, beetroot, ginger, cabbage, lime or lemon and orange will provide many benefits.
  • Foods high in sulfur such as garlic, onions, broccoli, cabbage, bok choy, kale, cauliflower, mustard greens, radishes, watercress and Brussels sprouts and eggs enhance the sulfation of toxins making them easier to excrete. Broccoli sprouts powder or capsules are very beneficial.

Sclerosing Cholangitis – An interesting Case History

I saw an interesting gentleman in my clinic diagnosed with Sclerosing Cholangitis and he wanted to treat it with nutritional medicine.  In some cases of Sclerosing Chlangitis, including this man’s case, there is also infection with bacteria in the bile ducts. When the infection flares up, this produces pain over the liver in the right upper abdomen, fever, sweating and muscle aches and pains. To control the infection this man had been prescribed daily antibiotic drugs. He was also prescribed Ursofalk which is a synthetic form of bile acids.

He felt generally well but wanted to treat the cause of his disease on a deeper level and that is why he came to consult me. The left lobe of his liver had been so badly damaged by this disease that it required to be surgically removed and this procedure is called a left hepatectomy. He was worried that the disease would gradually destroy the right lobe of his liver and was trying to avoid a liver transplant.

When I took his history I found that his diet was reasonable and he was Italian and grew his own vegetables in his garden and consumed a lot of olive oil, which is a good fat for the liver. He was physically active and did not drink excess alcohol.

I explained to him that the cause of the inflammation in his bile ducts was caused by two factors –

  1. Bacteria growing in the ducts
  2. Autoimmune dysfunction where his immune system was attacking the bile ducts

We had to address both these factors if we were to reduce the inflammation that could continue to destroy his bile ducts and the liver cells surrounding the bile ducts.

To achieve these goals I prescribed the following strategy –

  • A gluten free diet, as his blood test for the HLADQ genotype had shown that he carried the genes for gluten intolerance.
  • A good liver tonic containing Milk Thistle, all the B group vitamins, selenium and Taurine
  • N Acetyl Cysteine (NAC) capsules in a dose of 600mg three times daily.
  • Vitamin C 1000mg daily to strengthen the bile ducts.
  • Natural vitamin E in a dose of 1000 IU daily which would reduce scarring.
  • An increased intake of water and raw juices to promote the flow of healthy bile. Suitable things to include in the juice are ginger, citrus, kale, cabbage, carrot, parsley and green apple.
  • An increased intake of essential fatty acids from oily fish, avocado, ground flaxseeds, hemp seeds, chia seeds and fresh walnuts.
  • A glutamine supplement in powder form to reduce inflammation in the gut and enhance the production of glutathione in the liver.
  • Natural antibiotics to reduce the amount of unhealthy bacteria in his intestines and bile ducts. This would reduce the source of the infection in his bile ducts, which was coming from the unhealthy bacteria in his intestines. Natural antibiotics include raw garlic, oregano, thyme and cloves.

To increase the healthy bacteria in his intestines I prescribed a probiotic supplement and fermented foods such as coconut yogurt, organic apple cider vinegar, kefir and fermented vegetables.

Sesame seeds (best consumed as tahini paste or hummus) contain sesamin, which has liver protective effects.

An increased dietary intake of foods high in sulfur such as garlic, onions, chives, radishes and cruciferous vegetables and broccoli sprouts powder; these contain powerful protective liver factors such as sulforaphane and Indol-3-carbinol.

Green tea which contain catechins to provide many supportive effects on liver detoxification.

Citrus fruits and caraway oil contain D-Limonene, which enhances elimination of carcinogenic metabolites from the liver.

I have had many patients with autoimmune diseases of the liver, ranging from autoimmune hepatitis, Primary Biliary Cirrhosis (PBC) and Sclerosing Cholangitis, who have been able to get their liver function back to normal and arrest the inflammation in their liver. This will stop the disease process and prevent cirrhosis.This takes a little bit of effort and a change in diet for many sufferers but the outcome achieved is well worth the effort.

Nutritional medicine is evidence based and very scientific and needs to be used much more widely in liver clinics.

The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.




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